ABSTRACT
Mammography is the primary imaging modality in breast cancer screening and diagnostic examination. It has been shown that mortality and morbidity associated with breast cancer are reduced by mammographic screenings. A standardized approach to lesions is important for differential diagnosis and correct guidance. The Breast Imaging Reporting and Data Recording System atlas, which was developed by the American Collage of Radiology and was last updated in 2013, is used in the evaluation of the findings. Lesions are categorized as mass and non-mass findings. Non-mass findings are classified as calcifications, asymmetry and structural distortions, and will be discussed in this chapter.
References
1Wilkinson L, Thomas V, Sharma N. Microcalcification on mammography: approaches to interpretation and biopsy. Br J Radiol 2017; 90: 20160594.
2Hernández PLA, Estrada TT, Pizarro AL, Cisternas MLD, Tapia CS. Breast calcifications: description and classification according to BI-RADS 5th Edition. Revista Chilena de Radiología 2016; 22: 80-91.
3Barreau B, de Mascarel I, Feuga C, MacGrogan G, Dilhuydy MH, Picot V, et al. Mammography of ductal carcinoma in situ of the breast: review of 909 cases with radiographic-pathologic correlations. Eur J Radiol 2005; 54: 55-61.
4Esen G, Tutar B, Uras C, Calay Z, İnce Ü, Tutar O. Vacuum-assisted stereotactic breast biopsy in the diagnosis and management of suspicious microcalcifications. Diagn Interv Radiol 2016; 22: 326-33.
5Stehouwer BL, Merckel LG, Verkooijen HM, Peters NH, Mann RM, Duvivier KM, et al. 3-T breast magnetic resonance imaging in patients with suspicious microcalcifications on mammography. Eur Radiol 2014; 24: 603-9.
6D’Orsi CJ, Sickles EA, Mendelson EB, Morris EA. American College of Radiology [ACR] Breast Imaging Reporting and Data System Atlas [BI-RADS Atlas], 5th ed. American College of Radiology 2013.
7Sickles EA. Breast calcifications: mammographic evaluation. Radiology 1986; 160: 289-93.
8Linden SS, Sickles EA. Sedimented calcium in benign breast cysts: the full spectrum of mammographic presentations. AJR Am J Roentgenol 1989; 152: 967-71.
9Cardenosa G. Breast Imaging. Lippincott Williams & Wilkins, Philadelphia, PA (2004).
10Kim SY, Kim HY, Kim EK, Kim MJ, Moon HJ, Yoon JH. Evaluation of malignancy risk stratification of microcalcifications detected on mammography: a study based on the 5th edition of BI-RADS. Ann Surg Oncol 2015; 22: 2895-901.
11Henrot P, Leroux A, Barlier C, Génin P. Breast microcalcifications: the lesions in anatomical pathology. Diagn Interv Imaging 2014; 95: 141-52.
12Lazarus E, Mainiero MB, Schepps B, Koelliker SL, Livingston LS. BI-RADS lexicon for US and mammography: interobserver variability and positive predictive value. Radiology 2006; 239: 385-91.
13Rominger M, Wisgickl C, Timmesfeld N. Breast microcalcifications as type descriptors to stratify risk of malignancy: a systematic review and meta-analysis of 10665 cases with special focus on round/punctate microcalcifications. Rofo 2012; 184: 1144-52.
14Chen PH, Ghosh ET, Slanetz PJ, Eisenberg RL. Segmental breast calcifications. AJR Am J Roentgenol 2012; 199: W532-42.
15Oktay A. Evaluation of microcalcifications and BI-RADS. Turkiye Klinikleri J Radiol-Special Topics. 2017; 10: 198-204.
16Arıbal E. Mamografide bulguların değerlendirilmesi. Meme Hastalıklarında Görüntüleme. Dünya Tıp Kitapevi 2014; 91-106.
17Oktay A. Radyolojik patolojik korelasyon; yüksek risk lezyonlarda ne yapmalıyız? Trd Sem 2014; 2: 217-29.
18Wilkinson L, Thomas V, Sharma N. Microcalcification on mammography: approaches to interpretation and biopsy. Br J Radiol 2017; 90: 20160594.
19Gurando AV, Babkina TM, Dykan IM, Kozarenko TM, Gurando VR, Telniy VV. Digital breast tomosynthesis and full-field digital mammography in breast cancer detection associated with four asymmetry types. Wiad Lek 2021; 74: 842-8.
20Chesebro AL, Winkler NS, Birdwell RL, Giess CS. Developing Asymmetries at mammography: a multimodality approach to assessment and management. Radiographics 2016; 36: 322-34.
21Johnson B. Asymmetries in mammography. Radiol Technol 2021; 92: 281M-98M.
22Harvey JA, Nicholson BT, Cohen MA. Finding early invasive breast cancers: a practical approach. Radiology 2008; 248: 61-76.
23[Price ER, Joe BN, Sickles EA. The developing asymmetry: revisiting a perceptual and diagnostic challenge. Radiology 2015; 274: 642-51.
24Giess CS, Chesebro AL, Chikarmane SA. Ultrasound features of mammographic developing asymmetries and correlation with histopathologic findings. AJR Am J Roentgenol 2018; 210: W29-38.
25Leung JW, Sickles EA. Developing asymmetry identified on mammography: correlation with imaging outcome and pathologic findings. AJR Am J Roentgenol 2007; 188: 667-75.
26Chesebro AL, Winkler NS, Birdwell RL, Giess CS. Developing Asymmetry at mammography: correlation with US and MR ımaging and histopathologic findings. Radiology 2016; 279: 385-94.
27Dibble EH, Lourenco AP, Baird GL, Ward RC, Maynard AS, Mainiero MB. Comparison of digital mammography and digital breast tomosynthesis in the detection of architectural distortion. Eur Radiol 2018; 28: 3-10.
28Bluemke DA, Gatsonis CA, Chen MH, DeAngelis GA, DeBruhl N, Harms S, et al. Magnetic resonance imaging of the breast prior to biopsy. JAMA 2004; 292: 2735-42.
29Vijapura C, Yang L, Xiong J, Fajardo LL. Imaging features of nonmalignant and malignant architectural distortion detected by tomosynthesis. AJR Am J Roentgenol 2018; 211: 1397-404.
30Partyka L, Lourenco AP, Mainiero MB. Detection of mammographically occult architectural distortion on digital breast tomosynthesis screening: initial clinical experience. AJR Am J Roentgenol 2014; 203: 216-22.
31Bachert SE, Jen A, Denison C, Kwait D, Rhei E, Karimova J, et al. Breast lesions associated with mammographic architectural distortion: a study of 588 core needle biopsies. Mod Pathol 2022; 35: 728-38.
32Durand MA, Wang S, Hooley RJ, Raghu M, Philpotts LE. Tomosynthesis-detected architectural distortion: management algorithm with radiologic-pathologic correlation. Radiographics 2016; 36: 311-21.
33Li Y, He Z, Ma X, Zeng W, Liu J, Xu W, et al. Architectural distortion detection based on superior-inferior directional context and anatomic prior knowledge in digital breast tomosynthesis. Med Phys 2022; 49: 3749-68.
34Villa-Camacho JC, Bahl M. Management of architectural distortion on digital breast tomosynthesis with nonmalignant pathology at biopsy. AJR Am J Roentgenol 2022; 219: 46-54.
35Baker JA, Rosen EL, Lo JY, Gimenez EI, Walsh R, Soo MS. Computer-aided detection (CAD) in screening mammography: sensitivity of commercial CAD systems for detecting architectural distortion. AJR Am J Roentgenol 2003; 181: 1083-8.
36Bahl M, Baker JA, Kinsey EN, Ghate SV. Architectural distortion on mammography: correlation with pathologic outcomes and predictors of malignancy. AJR Am J Roentgenol 2015; 205: 1339-45.
37Galati F, Moffa G, Pediconi F. Breast imaging: beyond the detection. Eur J Radiol 2022; 146: 110051.
38Suleiman WI, McEntee MF, Lewis SJ, Rawashdeh MA, Georgian-Smith D, Heard R, et al. In the digital era, architectural distortion remains a challenging radiological task. Clin Radiol 2016; 71: e35-40.
